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Suprachoroidal Hemorrhages – Review and Clinical Cases

ABSTRACT Introduction: Suprachoroidal Hemorrhage (SCH) is a potentially devastating complication of both anterior and posterior segment surgery. Although rare, it can occur following corneal transplants, glaucoma or cataract surgery, and vitreoretinal surgery or trauma. SCH may occur when a fragile vessel is exposed to sudden compression and decompression forces. Systemic risk factors include advanced age, arteriosclerosis, hypertension and...

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Combined Artificial Iris-IOL Implantation in Traumatic Aphakia-Aniridia

EDITED FILM ABSTRACT Iris defects combined with crystalline lens abnormalities are among the major complications of globe blunt trauma. Post-traumatic partial or total iris defects can cause glare, reduced contrast sensitivity, decreased vision, photophobia as well as cosmetic problems. When there is extensive iris damage repair may be impossible and artificial iris implants can be used to restore iris diaphragm, reducing aniridia...

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Internal Limiting Membrane in Macular Surgery

EDITED FILM ABSTRACT The internal limiting membrane (ILM) is a thin, transparent, acellular membrane that forms the innermost boundary of the retina. ILM is the basal lamina of the inner retina, it is formed by the footplates of Müller cells and is composed of collagen fibers, glycosaminoglycans, laminin, and fibronectin. It has an important role in the early stages of retinal and optic nerve development, as a critical component of...

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Managing Giant Retinal Tears 2 Cases Report

Managing Giant Retinal Tears 2 Cases Report ABSTRACT Introduction: Retinal detachments with giant retinal tears (GRT) pose a significant challenge, even to the most experienced vitreoretinal specialists. The extent of the primary lesion complicates management and tamponade choices, carrying the risk of the flap folding over post-operatively and re-detaching the retina. The authors present two cases of a retinal detachment with giant...

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Ocriplasmin for Treatment of Vitreomacular Traction: Our Real-world Experience

Ocriplasmin for Treatment of Vitreomacular Traction: Our Real-world Experience ABSTRACT Introduction: Pharmacologic vitreolysis with ocriplasmin is an effective nonsurgical treatment option for vitreomacular traction (VMT). Ocriplasmin is a truncated plasmin derivative approved as an intravitreal drug for release of focal vitreomacular tractions (<1500 μm), when accompanied by visual symptoms, and closure of macular holes (MH)...

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My Way to Perform the Inverted Flap Technique for MH

Introduction: Full-thickness idiopathic macular holes are foveal anatomic defects with a complete interruption of all retinal layers. This results in a significant visual impact for the patient. Current surgical options are constantly under debate, particularly after the new International Vitreomacular Traction Study Group classification. Various surgical options have been proposed to boost the closure rates in this disorder, namely...

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Entry-site Hemorrhage: When to Suspect and How to Manage it

Introduction: Vitreoretinal sutureless surgery has evolved in recent years into a safer, more effective group of procedures. It is, therefore, an unexpected sight to have a vitreous hemorrhage at the end of an otherwise uneventful vitrectomy. A possible cause of such a finding is an external hemorrhage that occurs immediatly after the removal of the trocars, that finds its way inside the vitreous cavity through the sclerotomy. Methods: The...

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A Retinal Detachment with Panuveitis and MH

Introduction: Any surgical pathology presenting with concomitant inflammation presents a dilemma to the eye surgeon, due to the increased risk of post-op complications. On the other hand, a retinal detachment presents an additional challenge to the vitreoretinal specialist in this situation. The authors present a clinical case with both these simultaneous conditions. Case Report: We present the case of a male 75 year-old patient, with a...

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A Macula-on RD with Multiple Giant Tears

Introduction: Retinal detachments with giant retinal tears pose a significant challenge, even to the most experienced vitreoretinal specialists. The extent of the primary lesion complicates management and tamponade choices, carrying the risk of the flap folding over post-operatively and re-detaching the retina. The authors present one case of a macula-on retinal detachment with multiple giant tears. Case report: The authors present the...

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ERM Negative Staining and Double Peeling with Brilliant Blue G

Introduction: Epiretinal membrane surgery is a demanding, state-of-the-art procedure. Vitreoretinal surgeons continuously seek to perfect their results, maximizing results and reducing complications and toxicity. Based on our belief and experience of the benefits of combined ERM and ILM peeling when removal of the former is indicated, we present our technique that we believe is both effective and safe. Methods: We present our adopted...

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Chronic Diffuse DME: The Role of Vitrectomy vs Intravitreal Therapy

Introduction: Macular edema is the main cause of visual loss in diabetic patients. In spite of the ample choice of therapeutic modalities, chronic macular edema management is a challenge to this date. Aside from laser and intravitreal therapies, the newest proposal by some authors has been vitrectomy with ILM peeling as a possible solution for many therapy-resistant cases, or even naive cases. Reducing traction, increasing retinal...

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Intraoperative Suprachoroidal Hemorrhage: Caught on Tape

Introduction: Intraoperative suprachoroidal hemorrhages are a feared complication of ophthalmological surgery. Caused by the rupture of posterior cilliary vessels, its rarity is only matched by its urgent need for immediate action. Although most frequently associated with glaucoma surgery and intra/extracapsular cataract extraction, it may rarely occur in the context of any intraocular procedure. In this paper, the authors present the case...

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A «Cascade» of Retinal Problems After a Complicated Cataract Surgery

Introduction: Nowadays cataract surgery is the most frequent eye procedure overall the world. In an experienced hand the complications are very limited. Neverthless, they happen and can even induce blindness. Clinical Case: The authors present one case of a patient with a cataract that was submited to a phaco with introduction of an I.O.L. in the posterior chamber. The procedure was complicated with posterior capsule rupture and vitreous...

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Entry Site Hemorrhage: An Uninvited Outsider

Introduction: Vitreous haemorrhages during vitrectomy are not an uncommon event, particularly in diabetic patients. However, intraoperative vitreous haemorrhages resulting from conjunctival and/or episcleral haemorrhages, after the successful closure of 23G scleral ports, is a rare finding, never before experienced by our surgical team. The authors present the case of a young man undergoing vitrectomy for persistent vitreous haze that had...

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Idiopathic Macular Hole: A Funny Trick and Different Inverted ILM Flap Techniques

Introduction: Idiopathic full thickness macular holes are foveal anatomic defects with interruption of all neurosensory retinal layers, resulting in visual and functional alterations with significant impact on the patient’s quality of life. Currently, the best therapeutic approach for macular holes is still being debated, after the new classification by the International Vitreomacular Study Group. Several surgical methods have been...

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Intraoperative Suprachoroidal Hemorrhage: Caught on Tape

Introduction: Intraoperative suprachoroidal hemorrhages are a feared complication of ophthalmological surgery. Caused by the rupture of posterior cilliary vessels, its rarity is only matched by its urgent need for immediate action. Although most frequently associated with glaucoma surgery and intra/extracapsular cataract extraction, it may rarely occur in the context of any intraocular procedure. In this paper, the authors present the case...

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